This study is designed (1) to evaluate and compare nurses knowledge of the epidemiology, pathogenesis, occupational risks, and appropriate prevention strategies for managing patients infected with bloodborne pathogens in the healthcare setting in four university hospitals in Japan and at the Clinical Center of the National Institutes of Health; (2) to compare self-reported levels of compliance with existing infection control recommendations designed to limit risk for exposure to bloodborne pathogens in all eight institutions; (3) to compare self-reported frequencies of cutaneous exposures to blood at the five hospitals in the study; and (4) to evaluate the effect of educational intervention on nurses perceived compliance with recommendations and on the frequency of self-reported exposures to blood. Approximately 2,000 Japanese and 500 Clinical Center nurses have completed the initial survey. Preliminary data analysis demonstrates a substantial difference in knowledge about bloodborne pathogens and a corresponding difference in frequency of blood exposures between the hospitals studied. An educational intervention has been designed and the first phase has been implemented. Nurses from Japan and the United States were resurveyed in early 2001, and the prelimiinary results appear to demonstrate substantial improvement in isolation technique and decreases in occupational exposures to blood.